Active NPI
Karl Harry Sembroski, PA-C
- Physician Assistant
- Tacoma, WA
National Provider Identifier
1972933505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60798354
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-1110 - Phone
- (253) 968-1110
- NPI assigned
- Nov 18, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | HI | ||
| Physician Assistant | 363A00000X | PA60798354 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-1110
Mailing address
9040 Jackson Ave
Tacoma, WA 98431-1110
Other practice location 1
3134 3rd division dr
Fort Lewis, WA 98433
Phone (253) 966-8155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2091057 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olympia Orthopaedic Associates PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Olympia, WA
- NPI 1083785398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1972933505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311110",
"telephone_number": "253-968-1110"
}
],
"practiceLocations": [
{
"address_1": "3134 3rd division dr",
"address_purpose": "LOCATION",
"city": "Fort Lewis",
"state": "WA",
"postal_code": "98433",
"country_code": "US",
"telephone_number": "253-966-8155",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEMBROSKI",
"first_name": "KARL",
"middle_name": "HARRY",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-18",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "HI",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60798354",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2091057",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.